GAD: It's All About Context

Generalized Anxiety Disorder (GAD) is one of the most prevalent mental health problems today. At any one time GAD affects around 4 to 5 per cent of the population. Of these around 80 per cent have some accompanying condition like depression. Like so many mental health issues questions surrounding its origins and development often hinge on nature v nurture. That is, how influential are genes or the environment when it comes to understanding and treating such issues?

GAD is characterized by excessive and uncontrollable worry usually, but not necessarily, related to areas of health, finances and other minor matters that become blown out of proportion. But before a diagnosis of GAD is reached a number of other symptoms such as irritability, sleep difficulties, muscle tension and problems with concentration also have to be evident for at least six months.

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But to what extent is GAD the result of some internal psychological mechanism? The answer isn’t clear but it does seem that context is important. Associate Professor Judith C. Baer and colleagues recently published some research that points to one cause of GAD as poverty. Studies of the poorest mothers, say the authors, point to them having the highest levels of GAD. And this, claim the authors, is nothing to do with an “internal malfunction” so much as “a reaction to severe environmental deficits”.

The danger in labeling a person with something like GAD is the assumption that the cause is some internal mental state. However, in situations like those reported by Baer and colleagues, it becomes clear that context is important. GAD can and does respond to treatment but if the cause is poverty then it stands to reason that “financial help and concrete services” are likely to be more appropriate.

Anxiety disorders are also associated with a number of physical conditions linked to poor quality of life and disability. GAD is recognized as a condition that carries a high cost in personal suffering. Suicidal thoughts and suicide attempts significantly increase, especially in women, especially when GAD is accompanied by depression.

Currently the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not embrace contexts such as poverty or other environmental deficits as a potential cause of GAD. But, as the authors say, “there is a physical need in the real world that is unmet and produces anxiety.”

Sources:

Rutgers University (2012, July 20). Anxiety disorders in poor moms likely to result from poverty, not mental illness, study suggests. ScienceDaily. Retrieved August 6, 2012, from http://www.sciencedaily.com­ /releases/2012/07/120720083312.htm